Time is growing short. We are less than six weeks from a Supreme Court decision on the fate of the ObamaCare subsidies on the Exchange that provide premium support for millions of Americans.
The King v. Burwell decision will be handed down at the end of June. If King prevails, as is expected, millions of Americans will lose their taxpayer-funded subsidies on the Exchange since the exact wording of the statute said these subsidies were available only on “exchanges established by the State.”
The White House response can be easily anticipated. President Obama and his minions will immediately call for Congress to “fix the law” by a simple re-wording of the statute to declare subsidies are available on the federal exchange. They will paint Republicans who oppose this as heartless obstructionists who don’t want what’s best for the American people.
Fortunately, Republicans have prepared responses – but must agree on the best one available. Karl Rove, former deputy chief of staff for President George W. Bush, writes in The Wall Street Journal that there are two general response approaches.
The first emphasizes providing transitional coverage for those affected by the loss of subsidies, while replacing selected elements of ObamaCare. The second also includes transitional coverage but puts more emphasis on replacing and reforming ObamaCare. Both approaches acknowledge the reality that wholesale repeal and replacement is impossible without a new Republican president.
First approach proponents include Senators Ron Johnson (R – WI) and Ben Sasse (R- NE). Both provide financial support to allow people who lose their subsidies to keep their current insurance plan. (Johnson until August, 2017; Sasse until 18 months after the court’s decision.)
Both plans link transitional coverage with changes to ObamaCare that would allow a new Republican president time to craft a full replacement plan. Johnson would repeal the Individual and Employer Mandates and states would be allowed to revise the “essential health benefits” provision that drives up the cost of insurance.
Second approach proponents include Representatives Paul Ryan, John Kline, and Fred Upton, all of who are committee chairmen in the House. They would provide a matching tax credit to provide temporary assistance with a robust package to reduce federal involvement in health care. They would allow states to opt out of the Individual and Employer mandates, give small businesses the ability to risk pool and allow people to buy policies across state lines (both would lower costs).
Rep. Upton has also teamed with Senators Orrin Hatch (R-UT) and Richard Burr (R-N.C.) to provide an even more comprehensive package, which provides a tax credit people could use to purchase insurance or fund a Health Savings Account (HSA). They would repeal the Individual Mandate and make insurance portable (like a 401-K) so you could take it with you when you change jobs.
Senator Hatch has also teamed with Senators Lamar Alexander (R-TN) and John Barrasso (R-WY) with a proposal that provides transitional relief while granting states without exchanges the freedom to create competitive health insurance markets. States with exchanges could remain in ObamaCare or opt out for this new system.
All this may seem confusing – and that’s the problem. Senator Johnson has called for simplicity and that seems prudent. Republicans must consolidate their ideas under one plan that can be quickly passed through both houses of Congress and sent to President Obama’s desk for signature. Then, if Obama vetoes it, he can get the blame for millions of people losing their health insurance – not Republicans who couldn’t agree on the best response.